| NPI | 1063717973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1422) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 1045) |
| 101YP2500X Counselor Professional (Licence: NE 2096) | |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2021-02-03 |